| NPI | 1205909520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: CO 1662) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: WA NT00001533) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2011-11-01 |